title: Influence of ethnicity on the efficacy and utilization of bariatric surgery in the USA.
abstract: BACKGROUND
  Ethnic disparities in patterns of utilization and outcomes after Roux-en-Y gastric bypass surgery (RYGB) were examined from Bariatric Outcomes Longitudinal Database.
  
  
  METHODS
  Descriptive statistics were used for demographics of Whites, Blacks, or Hispanics undergoing RYGB with 1 year of follow-up, between June 2007 and October 2011. Multivariate logistic and normal regression models, controlling for baseline characteristics, examined relationships between race and outcomes. T tests were used for continuous variables and Pearson chi-square test for categorical variables.
  
  
  RESULTS
  Study patients (108,333) were79 % White, 12 % Black, and 9 % Hispanic. Fewer Black males underwent surgery (15 %) compared to Whites or Hispanics (∼22 %). Blacks compared to Whites were younger (42.7 ± 10.6 vs. 46.4 ± 11.6 years), heavier BMI (50 ± 9.1 vs. 47.4 ± 8.0 kg/m(2)), and more often hypertensive (57 vs. 52 %). Other comorbidities were higher in Whites. Thirty-day mortality rate was equivalent (0.23-0.26 %), but serious adverse events were higher for Blacks (3.65 %) versus Whites (3.19 %) and Hispanics (2.01 %). At 1 year, weight and comorbidity burden declined significantly but less in Blacks despite adjustment for baseline characteristics.
  
  
  CONCLUSIONS
  Fewer Black males underwent RYGB. Despite a smaller percent decline in BMI and comorbidities in Blacks, all races benefitted significantly from RYGB. Influence of other factors such as diet, culture, and genetics needs to be investigated further.
authors.affiliation: Duke University Medical Center, Durham, 27710, NC, USA, Ranjan.Sudan@duke.edu.
authors.forename: Ranjan
authors.initials: R
authors.lastname: Sudan
authors.forename: Deborah
authors.initials: D
authors.lastname: Winegar
authors.forename: Steven
authors.initials: S
authors.lastname: Thomas
authors.forename: John
authors.initials: J
authors.lastname: Morton
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D015992:Body Mass Index; D015897:Comorbidity; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000706:statistics & numerical data*; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000601:surgery*; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000706:statistics & numerical data